Self Help Clinic Celebrates 25 Years

"Self
Help," the ability to understand, care for, and make one's own decisions,
is a cornerstone concept in the women's health movement.

The following
article written by Cindy Pearson appeared in the March/April 1996 issue of "Network
News," the newsletter of the National
Women's Health Network. The article describes the early self help clinic where
women learned about their bodies from their own experience and sharing with each
other. NWHN is a national organization dedicated to women's health. This article
is republished here with permission from NWHN.

On
April 7, 1971, thirty women met together to talk about "breaking through"
the abortion issue by working on women having control over their reproduction,
rather than continuing previous efforts aimed at influencing hospitals, doctors
and legislators. Twenty-five years later, the movement started that evening has
not only had an enormous impact on abortion care in the United States, but has
also affected the manner in which routine health care is provided to millions
of women and the relationship that thousands of women have with their own bodies.

What happened at that meeting? Self Help Clinic began. Like many others
at the 1971 meeting, Carol Downer was a reproductive health activist in her local
NOW chapter. After a visit to a clandestine abortion clinic, she had gone home
with a plastic vaginal speculum. At the 1971 gathering, she demonstrated how women
could use speculums with mirrors and flashlights to see their own and each other's
cervixes. Women took turns doing self exam and talked about the importance of
doing self exam in a group setting where they
could see the range of normal, healthy women's experiences. The group also talked
about the new abortion equipment in use at some clinics -- a flexible plastic
cannula attached to a syringe--and one member of the group, Lorraine Rothman,
volunteered to modify it for safe use by non-professionals.

The techniques
eventually developed by Rothman and Downer were entitled menstrual extraction,
to differentiate them from abortion in the medical setting. Menstrual Extraction,
or ME, was never envisioned as a service that lay women practitioners would provide
to other women who needed an abortion. Rather, the early self helpers advocated
that women join self help groups and practice extracting each other's menses around
the time of their expected periods. If a pregnancy happened to be present, it
would be extracted along with the contents of the uterus. The self helpers believed
that their experience with each other, the modified nature of the equipment they
were using, and the fact that they were ending pregnancies far earlier than was
typical during an abortion would make menstrual extraction safe.

In order
for self help and menstrual extraction to be the strategy that allowed women to
"break through" the abortion issue, women everywhere would need to know
about it. Helped along by the presence in Los Angeles of thousands of women attending
a NOW (National Organization for Women) convention in August, 1971, self help
began to spread across the nation. After distributing a flyer announcing just
one hour-long meeting about self examination, the original self help group found
themselves sharing self help with small groups of women non-stop throughout the
entire conference. Leaving the meeting room with their speculums in brown paper
bags, these women went back to their local NOW chapters and started spreading
the word. In October, Downer and Rothman went on a six-week cross country tour
(via Greyhound bus!), sharing self help and menstrual extraction with women everywhere
from Wichita to New York City. Many long-lasting groups resulted.

Back
in Los Angeles, a core group of about a half a dozen women had been working together
throughout 1971. They had space at the Los Angeles Women's Center and held a self
help clinic on Wednesday nights that was open to everyone. They also shared self
help with women who dropped by during the week. At the same time, they began a
program of referring women for abortions, which gave them the power to negotiate
with physicians for better quality abortions--women were awake and supported by
an advocate while a physician performed a suction abortion on an out-patient basis.

In the meantime, the authorities were investigating the self helpers. Using
infiltrators, investigators hoped to catch the self helpers performing abortions.
In fact, when they finally raided the Self Help Clinic, the only evidence of criminal
activity they could gather was a container of yogurt used for vaginal yeast infections,
leading to the movement's lasting description of this episode as the Great
Yogurt Conspiracy. In December 1972, Carol Downer was acquitted by a jury
of charges that she was practicing medicine without a license. Many years later,
author Linda Gordon described this decision as establishing the precedent that
women's genitals were no longer territory reserved for men.

Shortly after,
as a result of the Roe v Wade Supreme Court decision, abortions could be provided
openly and independent of hospitals. The self helpers quickly established the
Los Angeles Feminist Women's Health Center, a woman-controlled clinic. Doctors
were hired by the self helpers to perform abortions, and many other services were
provided, including "well woman" care. A self help attitude permeated
the health care offered and the health center served as a base from which to continue
spreading Self Help Clinic. By 1975, there were nearly 2000 grassroots women's
health projects across the country and it had spread internationally. Though these
projects ranged from book-writing groups to women fighting against sterilization
abuse, many were woman-controlled clinics influenced by self help, some explicitly
in the Feminist Women's Health Center model, others similar, but less closely
aligned with the FWHCs.

During this period, the women's health movement
was at a high point of its influence. Abortion was as widely available and accessible
as it has ever been, before or since. Information about women's bodies and the
drugs, devices and procedures used on women became available to women through
books and an enormously expanded market for feminist health journalism. Medical
schools and individual physicians began to realize that the callous and insensitive
treatment many women received had to stop and took steps to reform medical training
(not to mention abolishing the unwritten quotas that had severely limited the
number of women allowed to enter medical school). Dangerous drugs and devices
were improved or taken off the market as a result of women's protests. Curbs were
placed on sterilization abuse. Challenges were posed to the US practice of funding
foreign birth control programs strictly for the purposed of population control,
not to empower women to control their own fertility. Many women came to believe,
in a way almost inconceivable during the heyday of physician control, that their
bodies were their own to understand and to control.

Along with all the
other strands of the women's health movement, Self Help Clinic played a key role
in these gains. Like other elements of the movement though, by the late 1970s
Self Help Clinic began to experience backlash. The strategy of establishing clinics
to offer women good health care and to serve as bases from which to spread self
help led many groups to spend endless hours fighting regulatory battles about
clinic licensing and the definition of "medical" services and who was
allowed to provide them. The economic hard times of the 1980s, followed quickly
by the anti-abortion violence, left many clinics unable to continue providing
services. Midway through the 1990s, relatively few women-controlled clinics exist.

However, the spark of Self Help Clinic is still alive. Several Feminist
Women's health Centers worked together to create three women's health books, A
Woman-Centered Pregnancy and Birth, A New View of a Woman's Body, and How to Stay
Out of the Gynecologist's Office. These books are available
from FWHC, in addition to information on self
examination (you can also order your very own speculum!).

Menstrual extraction, which
had receded into the background during the years in which abortion was relatively
available, was widely discussed in the mainstream press when the U.S. Supreme
Court considered overturning Roe v Wade, but instead narrowed it in the Casey
and Webster decisions. Self helpers even reprised the 1971 tour around that time,
sharing self examination and menstrual extraction with groups of women interested
in maintaining control over their reproduction regardless of the Supreme Court
rulings. Self help groups are continuing to meet, particularly on college campuses
and in cities with direct-action women's groups. Self Help Clinic is very much
alive in the lasting impact the women's health movement has had upon women, their
sense of their bodies , and the way in which health care provided to women has
improved over the past twenty-five years.

Cindy Pearson has been Program
Director at the National Women's
Health Network since 1987. From 1978 to 1985, she was a Director of a FWHC.
She has been a self helper for over 20 years.

If you live in Oregon, contact the Network for Reproductive
Options at 541-345-5702
to find out when they are next presenting the "Self Help
Slide Show" or to be more involved in sharing women's
health information.

More
than one third of the estimated 50 million abortions performed annually worldwide
are illegal, and nearly half of all abortions take place outside the health care
system, reports Population Action International.